Sputum smear conversion and its associated factors among sputum-positive pulmonary tuberculosis patients of a tribal community in West Bengal

Background: Tuberculosis (TB) is one of the oldest demonstrated diseases of the humankind. Although TB is a curable disease, still millions of people still suffer every year and a sizable number of them die from this infectious disease resulting in devastating social and economic impacts on the country. Aims and Objectives: The aim of this study was to estimate the sputum conversion time about initial bacterial load and to assess the factors associated with delay in sputum conversion among the study subjects. Materials and Methods: An observational, descriptive, and longitudinal study was conducted in in the District of Jhargram among 388 sputum smear-positive adult pulmonary TB (PTB) patients of the tribal community. Data were collected on a pre-designed and pre-tested questionnaire and was subsequently analyzed using suitable statistical package. Results: Most of the study participants had initial sputum sample bacterial load 3+; for most (81.22%), the sputum conversion occurred at 3 weeks. The majority (55.67%) of the study participants had delay in sputum conversion and among those maximum (54.38%) subjects had delay by 1 week. There is a significant association between tobacco and alcohol use and delay in sputum conversion. Most of the study participants (81.22%) having initial sputum grade 3+ had a delay in sputum conversion by 1 week. Conclusion: The study conducted among the Santhal community in Jhargram district, West Bengal, revealed that the majority of newly diagnosed adult PTB patients achieved sputum conversion after 3 weeks of treatment, with significant delays associated with high initial bacillary loads and substance use (tobacco and alcohol).